February 23, 2015

Stealth Research & “may they know the exact content of their stools”

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Dr. Richard Lehman, John Ioannidis, research hype, stealth research

Thanks to Dr. Richard Lehman for my morning chuckle and for providing a link to a serious concern.

Lehman, in his weekly journal review blog for The BMJ, writes:

“I once sat through a presentation by a Dutch medical entrepreneur in which we were shown the continuous monitoring environment of the future, in which every object around us would tell us about our physiology on a second-by-second basis. Either he had a very dry sense of humour, or he actually wanted this to happen. I think he was wearing some stupid kind of watch which monitors his heart rate, BP, and perhaps arterial oxygen saturation. He looks forward to the day when his lavatory will tell him all sorts of things about his urine and stools. Bring it on. John Ioannidis writes about this burgeoning world of “stealth research” in biomedicine, which is fed on hype, and completely bypasses the truth-seeking, time-consuming processes of real science. As they sow, so let them reap. May they know the exact content of their stools. I prefer my watch just to tell me the time, and to keep a good book handy in the lavatory.”

That link takes you to a piece in JAMA from last week by John Ioannidis of Stanford, “Stealth Research: Is Biomedical Innovation Happening Outside the Peer-Reviewed Literature?” It’s an important article. Excerpts:

“Information about Theranos, a privately held biotechnology company that has developed novel approaches for laboratory diagnostic testing, has appeared in The Wall Street Journal, Business Insider, San Francisco Business Times, Fortune, Forbes, Medscape, and Silicon Valley Business Journal—but not in the peer-reviewed biomedical literature. As of January 5, 2015, a search in PubMed using Theranos as a search term identified affiliations for only 2 unrelated articles coauthored by Theranos Inc employees, although these 2 reports do not offer insights about their company.

Conversely, according to the non–peer-reviewed sources mentioned above, Theranos is “revolutionizing the blood test” and this “is a golden idea”: “the company can run hundreds of tests on a drop of blood far more quickly than could be done with whole vials in the past—and it costs a lot less.” The company is estimated to be worth $9 billion. Test results are “near-instantaneous.” …

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Theranos is just one example among many for which major efforts and major claims about biomedical progress seem to be happening outside the peer-reviewed scientific literature.

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However, stealth research creates total ambiguity about what evidence can be trusted in a mix of possibly brilliant ideas, aggressive corporate announcements, and mass media hype.

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However, unless stealth research adopts more scientific transparency, investors, physicians, patients, and healthy people will not be able to judge whether some proposed innovation is worth $9 billion, $900 billion, or just $9—let alone if the innovation will improve the health and well-being of individuals.”

In the course of our work on this project, we see mass media hype of stealth research all the time. We have pointed it out in the past, and will continue to do so. But Ioannidis provides the context that is important. And Lehman provided the link, the reminder, and the humor. Thanks.

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